The following letter was sent to 2600 hospitals across the country. Over one hundred organizations - listed below - signed on to the letter calling on hospitals to stop allowing formula companies to market infant formula in their facilities.

March 30, 2012

Dear Chief Executive,

We strongly urge you to immediately discontinue the distribution of commercial infant formula manufacturer discharge bags in your facility. Many health care institutions are now scrutinizing the ethics and safety of commercial marketing and distribution of pharmaceutical products within their facilities; distribution of commercial discharge bags marketing infant formula is similarly unethical and contrary to good public health policy.

There is overwhelming consensus among all major health professional organizations regarding the health benefits of breastfeeding for mothers and babies and the importance of exclusive breastfeeding for the first six months of life.[1] Hospital promotion of infant formula through dissemination of these discharge bags contravenes this consensus, needlessly and inexcusably harming babies and families. Moreover, formula feeding imposes a significant burden on the nation’s economy. Breastfeeding saves families and the economy countless dollars.

When hospitals distribute formula samples, they participate in the marketing efforts of formula companies at the expense of patients. Moreover, by distributing samples, they imply that these products are medically approved and recommended. Yet, there is ample evidence that formula samples reduce breastfeeding duration and exclusivity. Multiple studies have shown that women who receive commercial hospital discharge packs stop breastfeeding sooner than those who do not.[2] Hospitals expend resources to support mothers to breastfeed, but reduce the impact of these efforts by distributing formula samples. Research shows that bag distribution sends a message more powerful than any verbal messages.[3] New mothers who at first experience difficulty breastfeeding are apt to choose to use free formula samples given to them in discharge bags instead of seeking out assistance with breastfeeding. Aware of these dangers, in 1981 the WHO established the International Code of Marketing of Breast-milk Substitutes.[4] The Code states that healthcare facilities are not to be used for the marketing of infant formula. Hospitals in the U.S. that continue to distribute formula samples are in violation of the WHO Code.

Your hospital aims to promote the health of infants and mothers, but the ongoing promotion of infant formula conflicts with this mission. In 2009, the Centers for Disease Control and Prevention’s mPINC study found that 34.2 percent of hospitals nation-wide had stopped distributing formula samples.[5] This was an increase from 2007, when only 27.4 percent of hospitals had discontinued the sample bags.[6] Recently, Rhode Island became the first state where all birthing hospitals have banned the distribution of formula samples.[7] This is important progress but far from sufficient. We urge your hospital to join those hospitals that refuse to act as marketing agents for formula companies. We look forward to your response, and would be pleased to discuss these matters with you further.

Sincerely,

Robert WeissmanPresident, Public Citizen

On behalf of:

National Organizations

Academy of Breastfeeding MedicineAmerican Academy of NursingAmerican College of Nurse-MidwivesAmerican Medical Student AssociatioAmerican Public Health AssociationAssociation of State & Territorial Public Health Nutrition DirectorsBan the BagsThe Best for Babes Foundation, Inc.Center for Science in the Public InterestCoalition for Improving Maternity ServicesConsumers UnionEvery Mother, Inc.Food and Water WatchHealthConnect OneHealthy Children Project, Center for BreastfeedingHuman Milk Banking Association of North America